AB0116 NEW INFLAMMATORY MARKERS IN SYSTEMIC LUPUS ERYTHEMATOSUS AND ANTIPHOSPHOLIPID SYNDROME
Authors: K. Nurbaeva, T. Reshetnyak, F. Cheldieva, M. Cherkasova, E. Samarkina, A. Lila
Journal: Annals of the Rheumatic Diseases (2022)

Background Thromboinflammation is a pathological process that is associated with uncontrolled inflammation, leading to hypercoagulability and thrombotic complications. Systemic lupus erythematosus (SLE) and antiphospholipid syndrome (APS) are prototypical chronic thromboinflammatory diseases. Neutrophils are important cells in the development of systemic inflammation and thrombosis. Neutrophil reactivity (NEUT-RI), neutrophil granularity (NEUT-GI), immature granulocytes (IG), and neutrophil-to-lymphocyte ratio (NLR) are considered as inflammatory markers. Objectives To determine the role of parameters of neutrophil activation (NEUT-RI, NEUT-GI), immature granulocytes (absolute (IG#), relative (IG%) counts), NLR, ESR in assessing inflammation in SLE, primary APS (PAPS), and SLE with APS. Methods The study included 80 patients and 40 healthy donors (HD). Patients were classified into three groups: Group 1 included 37 patients with SLE. The median age of patients with SLE was 34 years [28-43]. Group 2 included 20 patients with SLE+ APS (45 years [37-49]). Group 3 included 23 patients with PAPS (38 years [34,5-47,5]). Current disease activity was evaluated with SLEDAI-2K and adjusted GAPSS (aGAPSS). A complete blood count (WBC-white blood cell, NEUT#-absolute neutrophil count, NEUT-RI, NEUT-GI, IG%, IG count, NLR, thrombocytes, ESR-erythrocyte sedimentation rate) was performed with XN-1000 automated hematology analyzer (Sysmex, Japan). Results Patient characteristics are shown in Table 1. IG# and IG% levels were significantly increased in patients with SLE and SLE+APS compared to controls and PAPS. ESR levels was significantly higher in patients with SLE, SLE+APS, and PAPS compared to HD. There was no significant difference between NEUT-RI, NEUT-GI, NLR, fibrinogen and CRP levels in patients with SLE, SLE+APS, PAPS, and HD. The aGAPPS was positively correlated with the IG# (r s =0.46; р=0.028) and IG% levels (r s =0.49; р=0.017) in patients with PAPS. No correlation was found between the IG and SLEDAI 2K. The ESR was positively correlated with SLEDAI 2K in SLE patients (r s =0.54; р≤0.001). Table 1. Characteristics of patients with SLE, PAPS, SLE+APS, and healthy controls. ParametersM±SD, Me [25%; 75%], n (%) SLE (n=37) PAPS (n=23) SLE+APS (n=20) Healthy donors (n=40) p SLEDAI 2K 7 [3.5-13] - 4 [2-8] - р=0.03* Anti-dsDNA, IU/ml 41.6 [13.6-101] - 22.2 [10.7-69.9] - NS aCL IgG,n,% 2 (5.4) 16 (69.5) 11 (55.0) - p&lt;0.001* aCL IgM,n,% 0 4 (19) 1 (5) - P=0.034* aB2GP1 IgG,n,% 2 (5.4) 15 (65.2) 11 (55.0) - p&lt;0.001* aB2GP1 IgM,n,% 1 (2.7) 5 (21.7) 1 (5) - P=0.053* LA positivity, n,% 1 (2.7) 15 (65.2) 9 (45) - p&lt;0.001* Triple positive,n, % - 14 (60.8) 7 (35) - NS WBC, 10 9 /l 5.1 [3.8-7] 5.6 [4.7-6.7] 6.4 [4.9-7.7] 6.2 [5.3-6.9] NS Thrombocytes, 10 9 /l 231 [201-300] 223.5 [189.5-270] 226 [168-278] 251 [210-290] NS NEUT#,10 9 /l 2.89 [1.84-3.71] 3.6 [2.71-4.4] 3.3 [3.1-5] 3.55 [2.9-4.4] NS NEUT-RI, FI 45.5 [43.8-47.3] 44.2 [43.1-45.9] 45.1 [43.5-47.3] 44.0 [42.7-46.2] NS NEUT-GI, SI 155.6 [151.6-158.0] 154.85 [153.7-156.1] 154 [151.2-157.8] 153.7 [150.2-155.7] NS NLR 1.8 [1.3-2.5] 2.1 [1.4-3.1] 2.3 [1.6-2,8] 1.9 [1.5-2.4] NS ESR, mm/h 13 [7-20] 14 [6.5-18] 16 [13-19] 7 [4-11] p&lt;0.001* IG#,10 9 /l 0.02 [0.01-0.07] 0.01 [0.01-0.02] 0.03 [0.02-0.05] 0.01 [0.01-0.02], p=0.002* IG% 0.4 [0.3-1.1] 0.2 [0.2-0.4] 0.4[0.3-0.7] 0.2 [0.2-0.3] p&lt;0.001* CRP, mg/l 2.2 [0.6-3.8] 1.15 [1-1.4] 2.5 [1.7-6.3] - NS Fibrinogen, g/l. 3.15 [2.8-3.6] 3.35 [2.84-3.76] 3.21 [2.9-3.8] - NS *a statistically significant test result (p &lt; 0.05); NS-not significant;FI- fluorescence intensity; SI- scatter intensity; fl- femtoliter. Conclusion Patients with SLE and SLE+APS had significantly higher levels of immature granulocytes than controls and PAPS patients. In PAPS, immature granulocytes were positively correlated with aGAPSS values. The study was performed at V.A. Nasonova Research Institute of Rheumatology within the framework of the fundamental research FURS-2022-003. Disclosure of Interests None declared